Understanding Risk Factors and Recognizing Stroke Symptoms May Save Lives

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Every 40 seconds someone in the United States has a stroke. Stroke is the fourth leading cause of death and the number one cause of adult disability in the country. While stroke often occurs without warning, understanding risk factors and learning to recognize symptoms can potentially save lives and limit damage if a stroke occurs. In recognition of National Stroke Awareness Month, Northwestern Medicine experts encourage consumers learn about their potential risk factors and start making lifestyle decisions that may decrease their likelihood of having a stroke.

"A stroke occurs when a blocked blood vessel or artery interrupts blood flow to part of the brain or when bleeding occurs in the brain," explains Richard Bernstein, MD, director of the stroke service at Northwestern Memorial Hospital and associate professor in the Ken and Ruth Davee Department of Neurology at Northwestern University Feinberg School of Medicine. "When blood flow is interrupted, the brain does not receive oxygen which causes brain cells to die. Depending on the severity of a stroke and where in the brain it occurred, speech, movement and memory may be impacted."

Sometimes called "brain attacks," strokes leave more than two thirds of survivors with lasting disability. While some stroke risk factors are impossible to change, others can be reduced or controlled with preventive lifestyle choices.

"Making healthy decisions can dramatically lower a person's risk of having a stroke," said Clyde Yancy, MD, associate director of Northwestern's Bluhm Cardiovascular Institute and chief of the division of cardiology at Northwestern Memorial and the Feinberg School. "We know that lifestyle factors including being overweight, consuming too much salt and fat, smoking and excessive drinking, and being sedentary can all increase a person's risk of stroke."

Medical conditions, especially high blood pressure or hypertension, high cholesterol and diabetes heighten the likelihood that a person will suffer a stroke. Stroke risk increases after age 55, though a stroke is possible at any age. African-Americans are at higher risk than Caucasians and men have a slightly higher occurrence than women. Family history is also an important indicator of a person's stroke risk.

"While not every stroke risk is controllable, understanding your own risk factors and taking steps to manage those that are lifestyle-based can help prevent a stroke," explained Yancy. "An overall healthy lifestyle that emphasizes weight management through regular exercise and a diet rich in fruits, vegetables and whole grains while avoiding high sodium and high-fat foods is important for overall health. If you have a medical condition, such as high blood pressure or cholesterol, work with your physician to create a plan to mange it through diet and exercise, as well as with medications to decrease stroke risk. Controlling blood pressure cannot be overemphasized as a way to reduce the likelihood of a stroke. Not smoking and limiting your drinking will also improve your overall health and decrease your likelihood of having a stroke."

People with preexisting medical conditions are also at an increased risk of stroke. Cardiovascular conditions including atrial fibrillation (irregular heartbeat) and poor circulation because of narrowed arteries heighten stroke risk. Neurological conditions including aneurysms and vascular malformations can cause bleeding in the brain, which is often the cause of stroke in young individuals. Proper treatment for these conditions plays an important role in risk reduction and prevention.

When a stroke occurs, rapid medical attention is crucial. When treatment is received promptly, a person has a far greater chance of surviving the stroke and more likely to have less lasting damage.

"Timing is critical when a stroke occurs and urgent treatment is required to prevent serious brain damage, so it's crucial to recognize the signs of a stroke," said Bernstein. "The most common type of stroke, an ischemic stroke which results from a blockage, can be treated with clot-busting drugs called TPA. However, it can only be given up to 4.5 hours after onset of stroke symptoms."

Immediate medical care should be sought if one or more of the following warning signs are observed: sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or sudden, severe headache with no known cause.

To remember the signs of stroke, the National Stroke Association recommends using the acronym FAST:

Face – Ask the person to smile. Does one side of the face droop?

Arms – Ask the person to raise both arms. Does one arm drift downward?

Speech – Ask the person to speak. Does the person have slurred speech or trouble speaking?

Time – If you observe any of the above signs, call 9-1-1.